| NPI | 1952525446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAELE LEE SHIPWAY Co Executive Director 715-675-3458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WI 2715) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-05-06 |